When free radicals (oxidants) are produced, they start chain reactions with cellular components such as DNA (deoxyribonucleic acid) or cell membrane that can cause a variety of cellular dysfunction. Free radicals have been implicated in many chronic diseases; such as cancer, cardiovascular, neurodegenerative and in aging. Normally, the body has mechanisms that can combat the adverse effects of free radicals and reduce the magnitude of damage they can produce. Such defense mechanisms involve what are known as antioxidants.
Also referred to as antioxidant agents, antioxidants can be defined as nutrients which often try to decrease the harmful effects of the free radicals on a person's body cells. Our body cells normally require oxygen for energy and growth. The body cells make use of oxygen to effectively generate energy and sustain life, and release free radicals as bi-products. The deeper, brighter colored vegetables and fruits contain higher concentrations of minerals, antioxidants and vitamins. Vitamin E and C are the body's two primary antioxidants.
Even with normal amount of free radicals in our bodies, antioxidants help us to keep the number in a healthy range. A variety of vegetables, fruits, nuts, legumes and whole grain cereals, tea, herbs and red wine are some of the richest sources of antioxidants (Tab. 1). The benefit of eating vegetables, whole grain food and fruits is that they all contain natural antioxidants.
If you can eat a diet of antioxidants rich foods, some of the health problems you may be able to reduce the risk of include:
Antioxidants can be categorized into two types:
1. Non-enzymatic antioxidants work by interrupting free radical chain reactions. Non-enzymatic antioxidants include vitamin C, vitamin E, plant polyphenols, carotenoids and glutathione (GSH). Glutathione has been called the “master antioxidant” and is found in every single cell of your body, maximizing the activity of all the other antioxidants.
Most antioxidants found in foods and supplements are of the non-enzymatic type. They boost your enzymatic antioxidant defense system by doing a "first sweep," disarming the free radicals, which helps prevent depletion of your enzymatic antioxidants.
2. Enzymatic antioxidants work by breaking down and removing free radicals. Enzymatic antioxidants are produced in your body, can not be supplemented orally.
Examples of antioxidants that can affect infertility treatment:
Vitamin E helps counter oxidative stress, which is associated with sperm DNA damage and reduced sperm motility. A hormone-antioxidant combination may improve sperm count and motility. Oral antioxidants given to males in couples undergoing in vitro fertilisation for male factor or unexplained subfertility result in significantly higher live birth rate.
Selenium, an essential micronutrient and a free radical-scavenger, works synergistically with Vitamin E to protect spermatozoa from the effects of oxidation and to improve motility, morphology and pregnancy rates.
Folate is required for the synthesis of DNA, transfer RNA, cysteine, and methionine, which are required during periods of rapid cell growth. Given the peri-conceptional period is a time of cellular growth, it was postulated that folate supplementation may improve reproductive outcomes.
Vitamin C and β –carotene may be associated with slight improvements in semen parameters.
Vitamin D improves the rate of low sperm motility.
Coenzyme Q10 therapy in male infertility show that oral supplementation with coenzyme Q10 increased seminal coenzyme Q10 levels, spermatozoa concentration and motility.
Oxidative stress (OS)
Oxidative stress (OS), a state characterized by an imbalance between pro-oxidant molecules including reactive oxygen and nitrogen species, and antioxidant defenses, has been identified to play a key role in the pathogenesis of subfertility in both males and females. The adverse effects of OS on sperm quality and functions have been well documented. In females, on the other hand, the impact of OS on oocytes and reproductive functions remains unclear. This imbalance between pro-oxidants and antioxidants can lead to a number of reproductive diseases such as endometriosis, polycystic ovary syndrome (PCOS), and unexplained infertility. Pregnancy complications such as spontaneous abortion, recurrent pregnancy loss, and preeclampsia, can also develop in response to OS.
There are different medical treatments one can turn to in order to treat alcohol addiction. These include pharmaceutical options as well as natural remedies. Some drugs are specifically designed to reduce the cravings for alcohol, while others cause one to experience symptoms of aversion if they have a drink; in essence conditioning their body to reject alcohol. Naltrexone and Acamprosate, classified as opioid antagonists, help to reduce the craving feeling for alcohol in a recovering alcoholic, and also serve to alleviate some of the effects of alcohol on a person's system.
Excessive alcohol consumption and the associated negative consequences are a major public health concern throughout the world. Policy initiatives also have demonstrated considerable effectiveness and include changes in the minimum legal drinking age, reductions in acceptable legal limits for blood alcohol concentration while operating a motor vehicle, as well as decreasing availability and access to alcohol for underage individuals. Primary prevention programs that have used exclusively educational approaches have received mixed results. Increasing effectiveness has been associated with prevention programs that have utilized a multi-component approach and have included educational initiatives with environmental changes.
Alcohol addiction is difficult to get rid of. It may even seem impossible but with persistence and determination one can overcome it. A person does not always need to visit a doctor or a rehabilitation center to get of the muddle unless the addiction has been very serious. Otherwise, the person can follow a specific regime and get himself free from past bad habits.
The number one most important factor affecting chances of conceiving is something that can be controled: the timing and frequency of intercourse in fertile window (refers to the most fertile days in menstrual cycle of women during which is the highest chance of conceiving).
Pregnancy is technically only possible during the five days before ovulation through to the day of ovulation. These six days are the ‘fertile window’ in a woman’s cycle, and reflect the lifespan of sperm (5 days) and the lifespan of the ovum (24 hours). If a woman has sex six or more days before she ovulates, the chance she will get pregnant is virtually zero. If she has sex five days before she ovulates, her probability of pregnancy is about 10%. The probability of pregnancy rises steadily until the two days before and including the day of ovulation. At the end of the ‘fertile window’, the probability of pregnancy declines rapidly and by 12-24 hours after she ovulates, a woman is no longer able to get pregnant during that cycle. For those women who are not aware of their ‘fertile window’ or when they ovulate, sexual intercourse is recommended every 2 to 3 days to help optimise their chance of conceiving.
A variety of methods have been developed to help individual women estimate the relatively fertile and the relatively infertile days in the cycle; these systems are called fertility awareness. Fertility awareness methods that rely on cycle length records alone are called calendar-based methods. Methods that require observation of one or more of the three primary fertility signs (basal body temperature, cervical mucus, and cervical position) are known as symptoms-based methods. Urine test kits are available that detect the LH surge. LH is luteinizing hormone also known as lutropin. It is a hormone produced by gonadotropic cells in the anterior pituitary gland. In females, an acute rise of LH-surge triggers ovulation. It occurs 24 to 36 hours before ovulation. Urine test kits are also known as ovulation predictor kits (OPKs). Computerized devices that interpret basal body temperatures, urinary test results, or changes in saliva are called fertility monitors.
There has been some speculation that couples who are trying to conceive should reduce the frequency of sexual intercourse during the fertile window to increase sperm supply. This is not true for most couples. While couples with known male factor issues should consult their doctor for the best intercourse strategy, couples with normal fertility and no known sperm issues should not reduce the frequency of intercourse in the fertile window. Probability of conception is increased with having intercourse multiple times in fertile window. While it is true that sperm concentrations decrease slightly with increasing intercourse frequency, frequent intercourse is still more likely to result in conception than infrequent intercourse for couples with no male factor fertility issues. Each additional act of intercourse within fertile window increases probability of conception for that cycle. Sex two to three times per week may improve fertility if the frequency was less than this.
Stop smoking is a process of discontinuing tobacco smoking. Cigarette smoking remains the leading preventable cause of death and disease in the developed world, and increasing the number of smokers successfully quitting is one of the most effective measures available to improve population health. Stop smoking isn’t easy but with the right tools and support quitting smoking is possible and will be one of the most rewarding achievements of your life.
Smoking is a practice in which a substance is burned and the resulting smoke breathed in to be tasted and absorbed into the bloodstream. Most commonly the substance is the dried leaves of the tobacco plant which contains nicotine, which is addictive, making the process of quitting often very prolonged and difficult.
Nicotine binds to nicotinic receptors in the brain that, in turn, cause an increase indopamine. Dopamine is the major chemical that stimulates reward centers in the brain. The brain recruits an opposing force to dampen the effects of nicotine and this causes tolerance (the reduction in the effect of nicotine). The onset of this opposing force and the fact that the brain becomes used to and dependent on nicotine to function normally is known as physical dependence. When nicotine intake is decreased, the brain's opposing force is now unopposed and this causes withdrawal symptoms.
Ways how stop smoking
It is important for men to discuss their anxiety regarding their ED with their partners. It will help them to reduce their fears while their partner will be able to help them to cope. When is necessary to assess their erectile function by qualified professionals - talk therapy may be the first treatment for men with erectile dysfunction, licensed therapist can ease sexual anxiety.
Cognitive Behavioural Therapy (CBT) or sex therapy could be helpful in treatment of psychological problems which could be contributing to erectile dysfunction. For sex the mind and body cooperation is very crucial and sometimes persistent feelings of stress and anxiety may actually lead to problems with erection. Anxiety, stress or even relationship troubles could be addressed during counselling. Also sex therapy which is focused on improving overall relationship between partners could be useful for some people. Sex therapy is aimed to overcome sex difficulties and is led by trained mental professionals or psychologists.
Egg donation is the process by which a woman donates eggs for purposes of assisted reproduction or biomedical research. For assisted reproduction purposes, egg donation typically involves IVF technology, with the eggs being fertilized in the laboratory; more rarely, unfertilized eggs may be frozen and stored for later use. Egg donation is a third party reproduction as part of ART.
Egg donor may have several reasons for donate her eggs:
Procedure
First step is choosing the egg donor by a recipient from the profiles on or clinic databases (or, in countries where donors are required to remain anonymous, they are chosen by the recipient's doctor based on recipient woman’s desired trait). This is due to the fact that all of the mentioned examinations are expensive and the agencies/clinics must first confirm that a match is possible or guaranteed before investing in the process.
Each egg donor is first referred to a psychologist who will evaluate if she is mentally prepared to undertake and complete the donation process. These evaluations are necessary to ensure that the donor is fully prepared and capable of completing the donation cycle in safe and success manner. The donor is then required to undergo a thorough medical examination, including a pelvic exam, blood tests to check hormone levels and to test for infectious diseases, Rh factor, blood type, and drugs and an ultrasound to examine her ovaries, uterus and other pelvic organs. A family history of approximately the past three generations is also required, meaning that adoptees are usually not accepted because of the lack of past health knowledge. Genetic testing is also usually done on donors to ensure that they do not carry mutations (e.g., cystic fibrosis) that could harm the resulting children; however, not all clinics automatically perform such testing and thus recipients must clarify with their clinics whether such testing will be done. During the process, which usually takes several months, the donor must abstain from alcohol, sexual intercourse, cigarettes, and drugs, both prescription and non-prescription.
Once the screening is complete and a legal contract signed, the donor will begin the donation cycle, which typically takes between three and six weeks. An egg retrieval procedure comprises both the egg donor's cycle and the recipient's cycle. Birth control pills are administered during the first few weeks of the egg donation process to synchronize the donor's cycle with her recipient's, followed by a series of injections which halt the normal functioning of the donor's ovaries. These injections may be self-administered on a daily basis for a period of one to three weeks. Next, FSH is given to the donor to stimulate egg production and increases the number of mature eggs produced by the ovaries. Throughout the cycle the donor is monitored often by a physician using blood tests and ultrasound exams to determine the donor's reaction to the hormones and the progress of follicle growth.
Once the doctor decides the follicles are mature, the doctor will establish the date and time for the egg retrieval procedure. Approximately 36 hours before retrieval, the donor must administer one last injection of hCG to ensure that her eggs are ready to be harvested. The egg retrieval itself is a minimally invasive surgical procedure lasting 20-30 minutes, performed under sedation (but sometimes without any). A small ultrasound-guided needle is inserted through the vagina to aspirate the follicles in both ovaries, which extracts the eggs. After resting in a recovery room for an hour or two, the donor is released. Most donors resume regular activities by the next day.
Laws by state
The legal status and compensation of egg donation has several models across states with examples:
During ICSI just one sperm is injected directly into the egg cytoplasm using a micromanipulative apparatus that transforms imperfect hand movements into fine and precise movements of micromanipulation tools.
Intracytoplasmic Sperm Injection (ICSI) is an assisted reproductive technique (ART) initially developed by Dr. Gianpiero D. Palermo in 1993 to treat male infertility. It is most commonly used in conjunction with in vitro fertilization (IVF). Following IVF procedure, the physician places the fertilized egg into the female’s uterus for implantation. Sperm are obtained by the same methods as with IVF: either through masturbation, by using a collection condom, or by surgically removing sperm from a testicle through a small incision (MESA, TESE). The females are treated with fertility medications for approximately two weeks prior to oocyte retrieval to stimulate superovulation, where the ovaries produce multiple oocytes rather than the normal one oocyte. The oocytes are retrieved by either laparoscopy, or more commonly, transvaginal oocyte retrieval. In the latter procedure, the physician inserts a thin needle through the cervix, guided by a sonogram and pierces the vaginal wall and then the ovaries to extract several mature ova. Before the embryologist can inject the sperm into the oocyte, the sperm must be prepared by washing and exposing it to various chemicals to slow the sperm movement and prevent it from sticking to the injection plate. Also, the oocytes are treated with hyaluronidase to single out the oocyte ready for fertilization by the presence of the first polar body. Then, one prepared sperm is injected into an oocyte with a thin needle. Often, embryologists try to fertilize several eggs so they can implant more than one into the uterus and increase the chance of at least one successful pregnancy. This also allows them to save extra embryos, using cryopreservation, in case later IVF rounds are needed.
After the embryologist manually fertilizes the oocytes, they are incubated for sixteen to eighteen hours and develop into a pronucleate eggs (successfully fertilized eggs about to divide into an embryo). The egg then grows for one to five days in the laboratory before the physician places it in the female’s uterus for implantation.
The chance of fertilization increases dramatically with ICSI compared to simply mixing the oocytes and sperm in a Petri dish and waiting for fertilization to occur unaided (classical IVF procedure). Studies have shown that successful fertilizations occur 50% to 80% of the time. Since the introduction of ICSI, intrauterine insemination (IUI) has decreased in popularity by 80%.
See full description of ICSI
Sperm donation is the donation by a male (known as a sperm donor) of his sperm (known as donor sperm), principally for the purpose of inseminating a female who is not his sexual partner. Sperm donation is a form of third party reproduction including sperm donation, oocyte donation, embryo donation, surrogacy, or adoption. Number of births per donor sample will depend on the actual ART method used, the age and medical condition of the female bearing the child, and the quality of the embryos produced by fertilization. Donor sperm is more commonly used for artificial insemination (IUI or ICI) than for IVF treatments. This is because IVF treatments are usually required only when there is a problem with the female conceiving, or where there is a “male factor problem” involving the female's partner. Donor sperm is also used for IVF in surrogacy arrangements where an embryo may be created in an IVF procedure using donor sperm and this is then implanted in a surrogate. In a case where IVF treatments are employed using donor sperm, surplus embryos may be donated to other women or couples and used in embryo transfer procedures.
On the other hand, insemination may also be achieved by a donor having sexual intercourse with a female for the sole purpose of initiating conception. This method is known as natural insemination.
The donation
Donor sperm and fertility treatments using donor sperm may be obtained at a sperm bank or fertility clinic. Here, the recipient may select donor sperm on the basis of the donor's characteristics, e.g. looks, personality, academic ability, race, and many other factors. Sperm banks or clinics may be subject to state or professional regulations, including restrictions on donor anonymity and the number of offspring that may be produced, and there may be other legal protections of the rights and responsibilities of both recipient and donor. Some sperm banks, either by choice or regulation, limit the amount of information available to potential recipients; a desire to obtain more information on donors is one reason why recipients may choose to use a known donor and/or private donation.
A sperm donor will usually donate sperm to a sperm bank under a contract, which typically specifies the period during which the donor will be required to produce sperm, which generally ranges from 6–24 months depending on the number of pregnancies which the sperm bank intends to produce from the donor. Donors may or may not be paid for their samples, according to local laws and agreed arrangements. Even in unpaid arrangements, expenses are often reimbursed. Depending on local law and on private arrangements, men may donate anonymously or agree to provide identifying information to their offspring in the future. Private donations facilitated by an agency often use a "directed" donor, when a male directs that his sperm is to be used by a specific person. Non-anonymous donors are also called known donors, open donors or identity disclosure donors.
Donor selection
A sperm donate must generally meet specific requirements regarding age (most often up to 40) and medical history. Potential donors are typically screened for genetic diseases, chromosomal abnormalities and sexually transmitted infections that may be transmitted through sperm. The donor's sperm must also withstand the freezing and thawing process necessary to store and quarantine the sperm. Samples are stored for at least 6 months after which the donor will be re-tested for sexually transmitted infections. This is to ensure no new infections have been acquired or have developed during the period of donation. If the result is negative, the sperm samples can be released from quarantine and used in treatments.
Screening includes:
Preparing the samples
A sperm donor is usually advised not to ejaculate for two to three days before providing the sample, to increase sperm count and to maximize the conception rate. A sperm donor produces and collects sperm by masturbation or during sexual intercourse with the use of a collection condom.
Sperm banks and clinics usually "wash" the sperm sample to extract sperm from the rest of the material in the semen. A cryoprotectant semen extender is added if the sperm is to be placed in frozen storage in liquid nitrogen, and the sample is then frozen in a number of vials or straws. One sample will be divided into 1-20 vials or straws depending on the quantity of the ejaculate and whether the sample is washed or unwashed. Following the necessary quarantine period, the samples are thawed and used to inseminate women through artificial insemination or other ART treatments. Unwashed samples are used for ICI treatments, and washed samples are used in IUI and IVF procedures.
Anonymity
Anonymous sperm donation occurs where the child and/or receiving couple will never learn the identity of the donor, and non-anonymous when they will. Non-anonymous sperm donors are, to a substantially higher degree, driven by altruistic motives for their donations.
Even with anonymous donation, some information about the donor may be released to the female/couple at the time of treatment. Limited donor information includes height, weight, eye, skin and hair color. In Sweden, this is all the information a receiver gets. In the US, on the other hand, additional information may be given, such as a comprehensive biography and sound/video samples.
Information made available by a sperm bank will usually include the race, height, weight, blood group, health, and eye color of the donor. Sometimes information about his age, family history and educational achievements will also be given.
Different factors motivate individuals to seek sperm from outside their home state. For example, some jurisdictions do not allow unmarried women to receive donor sperm. Jurisdictional regulatory choices as well as cultural factors that discourage sperm donation have also led to international fertility tourism and sperm markets.
Legal aspects
A sperm donor is generally not intended to be the legal or de jure father of a child produced from his sperm. Depending on the jurisdiction and its laws, he may or may not later be eligible to seek parental rights or be held responsible for parental obligations. Generally, a male who provides sperm as a sperm donor gives up all legal and other rights over the biological children produced from his sperm. However, in private arrangements, some degree of co-parenting may be agreed, although the enforceability of those agreements varies by jurisdiction.
Laws prohibits sperm donation in several countries: Algeria, Bahrain, Costa Rica, Egypt, Hong Kong, Jordan, Lebanon, Lithuania, Libya, Maldives, Oman, Pakistan, Philippines, Qatar, Saudi Arabia, Syria, Tajikistan, Tunisia, Turkey, UnitedArab Emirates, and Yemen.
See full description of Sperm donation
In vitro fertilization (IVF) is a process by which an egg is fertilised by sperm outside the body: in vitro . The process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova (egg or eggs) from the woman's ovaries and letting sperm fertilise them in a liquid in a laboratory. The fertilised egg (zygote) is cultured for 2–6 days in a growth medium and is then implanted in the same or another woman's uterus, with the intention of establishing a successful pregnancy.
IVF techniques can be used in different types of situations. It is a technique of assisted reproductive technology for treatment of infertility. IVF techniques are also employed in gestational surrogacy, in which case the fertilised egg is implanted into a surrogate's uterus, and the resulting child is genetically unrelated to the surrogate. In some situations, donated eggs or sperms may be used. Some countries ban or otherwise regulate the availability of IVF treatment, giving raise to fertility tourism. Restrictions on availability of IVF include to single females, to lesbians and to surrogacy arrangements. Due to the costs of the procedure, IVF is mostly attempted only after less expensive options have failed.
The first successful birth of a "test tube baby", Louise Brown, occurred in 1978. Louise Brown was born as a result of natural cycle IVF where no stimulation was made. Robert G. Edwards, the physiologist who developed the treatment, was awarded the Nobel Prize in Physiology or Medicine in 2010. With egg donation and IVF, women who are past their reproductive years or menopause can still become pregnant. Adriana Iliescu held the record as the oldest woman to give birth using IVF and donated egg, when she gave birth in 2004 at the age of 66, a record passed in 2006.
The main cause of idiopatic male infertility is low semen quality potentially linked with antisperm antibodies, sperm DNA damage, elevated levels of reactive oxygen species (ROS), and sperm dysfunction. Another possible cause is a low sperm count. In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility arises from the combination of these conditions. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.
